Provider Relations Specialist Jobs
Provider Relations Specialist jobs are open across healthcare systems, managed care organizations, insurance carriers, and physician networks, at every level from entry-level coordinator to senior specialist and manager, with specializations in credentialing, network development, and provider contracting. Scan the live roles below and apply to whichever ones fit.
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Showing 5 of 96+ Provider Relations Specialist jobs
Description
About the Role
The Market Provider Relations Specialist partners closely with physicians, practice leadership, and care teams to identify operational and clinical improvement opportunities, implement value-based care strategies, and support achievement of organizational performance goals. Through provider education, performance analysis, workflow optimization, and ongoing relationship management, this role helps practices improve patient outcomes, documentation accuracy, operational effectiveness, and financial performance.
The ideal candidate is relationship-driven, analytical, and passionate about helping providers succeed in a value-based care environment.
Our Values
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Serve as the primary point of contact for assigned provider practices and build strong relationships with physicians, office managers, practice administrators, and clinical staff
- Conduct provider meetings and site visits to review performance, discuss initiatives, address challenges, and support improvement efforts
- Support provider engagement, practice transformation, quality improvement, risk adjustment, utilization management, and value-based care initiatives
- Educate providers and practice staff on HEDIS, CMS Star Ratings, risk adjustment, documentation requirements, population health, and quality improvement programs
- Review provider performance reports and scorecards, identify improvement opportunities, and assist with development of action plans
- Support providers in improving documentation accuracy, coding practices, care gap closure, chronic disease management, and patient outcomes
- Assist with operational questions related to claims, referrals, authorizations, credentialing, provider data, and other provider service functions
- Partner with Quality, Risk Adjustment, Care Management, Medical Management, Claims, Contracting, Credentialing, and Operations teams to support provider success
- Monitor provider engagement activities, maintain accurate documentation, and provide updates on market and provider performance
- Support implementation of new programs, payer initiatives, regulatory requirements, and organizational priorities
Qualifications
- Bachelor's degree in Healthcare Administration, Public Health, Nursing, Business Administration, or a related field preferred, or an equivalent combination of education and relevant healthcare experience
- Minimum of three (3) years of experience in provider relations, healthcare operations, managed care, practice management, quality improvement, population health, risk adjustment, or a related healthcare field
- Experience working directly with physician practices preferred
- Experience supporting value-based care programs preferred
- Knowledge of provider office operations and healthcare delivery models
- Working knowledge of HEDIS, CMS Star Ratings, quality improvement, and risk adjustment principles
- Understanding of managed care, Medicare Advantage, ACOs, IPA operations, or population health programs preferred
- Strong analytical skills with the ability to interpret provider performance data and translate findings into actionable recommendations
- Strong relationship-building, communication, presentation, and facilitation skills
- Strong organizational and project management abilities with the ability to manage multiple priorities and deadlines
- Proficiency with Microsoft Office applications and reporting tools
- Experience supporting provider performance improvement initiatives
- Experience working within Medicare Advantage, Medicaid, ACO, IPA, or other value-based care models
- Experience with provider education, workflow optimization, and practice transformation initiatives
- Familiarity with utilization management, population health, and care coordination programs
Environmental Job Requirements and Working Conditions
- Our organization follows a hybrid work structure where the expectation is to work in-office and remotely on a weekly basis. The office is located at 19500 Highway 249, Suite 570, Houston, TX 77070.
- Regular travel throughout the assigned market, including visits to provider offices, clinics, and community locations, may be required.
- Ability to attend provider meetings, trainings, and market events as needed.
- The target pay range for this role is $75,000-$85,000 per year. Actual compensation will be determined based on geographic location, experience, qualifications, internal equity, and other job-related factors.
About Astrana Health, Inc.
Description
About the Role
The Market Provider Relations Specialist partners closely with physicians, practice leadership, and care teams to identify operational and clinical improvement opportunities, implement value-based care strategies, and support achievement of organizational performance goals. Through provider education, performance analysis, workflow optimization, and ongoing relationship management, this role helps practices improve patient outcomes, documentation accuracy, operational effectiveness, and financial performance.
The ideal candidate is relationship-driven, analytical, and passionate about helping providers succeed in a value-based care environment.
Our Values
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
- Serve as the primary point of contact for assigned provider practices and build strong relationships with physicians, office managers, practice administrators, and clinical staff
- Conduct provider meetings and site visits to review performance, discuss initiatives, address challenges, and support improvement efforts
- Support provider engagement, practice transformation, quality improvement, risk adjustment, utilization management, and value-based care initiatives
- Educate providers and practice staff on HEDIS, CMS Star Ratings, risk adjustment, documentation requirements, population health, and quality improvement programs
- Review provider performance reports and scorecards, identify improvement opportunities, and assist with development of action plans
- Support providers in improving documentation accuracy, coding practices, care gap closure, chronic disease management, and patient outcomes
- Assist with operational questions related to claims, referrals, authorizations, credentialing, provider data, and other provider service functions
- Partner with Quality, Risk Adjustment, Care Management, Medical Management, Claims, Contracting, Credentialing, and Operations teams to support provider success
- Monitor provider engagement activities, maintain accurate documentation, and provide updates on market and provider performance
- Support implementation of new programs, payer initiatives, regulatory requirements, and organizational priorities
Qualifications
- Bachelor's degree in Healthcare Administration, Public Health, Nursing, Business Administration, or a related field preferred, or an equivalent combination of education and relevant healthcare experience
- Minimum of three (3) years of experience in provider relations, healthcare operations, managed care, practice management, quality improvement, population health, risk adjustment, or a related healthcare field
- Experience working directly with physician practices preferred
- Experience supporting value-based care programs preferred
- Knowledge of provider office operations and healthcare delivery models
- Working knowledge of HEDIS, CMS Star Ratings, quality improvement, and risk adjustment principles
- Understanding of managed care, Medicare Advantage, ACOs, IPA operations, or population health programs preferred
- Strong analytical skills with the ability to interpret provider performance data and translate findings into actionable recommendations
- Strong relationship-building, communication, presentation, and facilitation skills
- Strong organizational and project management abilities with the ability to manage multiple priorities and deadlines
- Proficiency with Microsoft Office applications and reporting tools
- Experience supporting provider performance improvement initiatives
- Experience working within Medicare Advantage, Medicaid, ACO, IPA, or other value-based care models
- Experience with provider education, workflow optimization, and practice transformation initiatives
- Familiarity with utilization management, population health, and care coordination programs
Environmental Job Requirements and Working Conditions
- Our organization follows a hybrid work structure where the expectation is to work in-office and remotely on a weekly basis. The office is located at 19500 Highway 249, Suite 570, Houston, TX 77070.
- Regular travel throughout the assigned market, including visits to provider offices, clinics, and community locations, may be required.
- Ability to attend provider meetings, trainings, and market events as needed.
- The target pay range for this role is $75,000-$85,000 per year. Actual compensation will be determined based on geographic location, experience, qualifications, internal equity, and other job-related factors.
About Astrana Health, Inc.
See All 96 Provider Relations Specialist Jobs
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Find JobsProvider Relations Specialist Job Market
Who's Hiring
- Independent Living Systems14
- American Health Plans9
- Health Care Service Corporation4
- L.A. Care Health Plan3
- SKYGEN2
Top Industries Hiring
- Insurance
- Healthcare & Medical Services
What Employers Look For
The qualifications that appear most often in provider relations specialist jobs.
- Bachelor's degree in healthcare administration, business, or a related field
- Experience working with provider networks, managed care, or health insurance operations
- Proficiency with provider data management systems and credentialing platforms such as CAQH
- Strong knowledge of healthcare reimbursement, claims processing, or contract terms
- Excellent verbal and written communication skills for provider-facing and internal stakeholder work
- Familiarity with NCQA or URAC accreditation standards and network adequacy requirements
Tips for Your Provider Relations Specialist Job Search
Tailor your resume to credentialing language
Provider relations roles split between network development and credentialing support, and job postings signal which side they lean. Mirror the exact terms from each posting, whether that's CAQH enrollment, provider onboarding, or network adequacy, so your resume clears automated screening.
Apply early to roles that fit
Migrate Mate lists provider relations specialist openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Highlight conflict resolution and escalation experience
Many hiring managers screen specifically for candidates who've handled provider disputes or reimbursement complaints. Call out any examples where you de-escalated a billing conflict, resolved a credentialing delay, or turned around a dissatisfied provider relationship.
Target openings by payer type and market
Medicaid managed care, Medicare Advantage, and commercial insurance plans operate differently, and your background in one doesn't always translate cleanly to another. Filter your search by the payer environment you know best to maximize your fit score with hiring teams.
Prepare for scenario-based interview questions
Interviewers often present a provider threatening to leave the network or a billing dispute that's stalled for months. Prepare two or three concrete examples that walk through how you identified the root cause, who you engaged, and what the outcome was.
Negotiate using productivity metrics, not just tenure
When discussing compensation, reference measurable outcomes: provider retention rates you influenced, onboarding timelines you shortened, or complaint volumes you reduced. Payers and health systems respond to operational impact more than years of experience alone.
Provider Relations Specialist Jobs: Frequently Asked Questions
Which companies are hiring the most provider relations specialists?
The most active employers for provider relations specialists right now are Independent Living Systems, American Health Plans, and Health Care Service Corporation, and the most openings are in Florida, Texas, and California, based on current listings on Migrate Mate as of November 2026. Health plans, hospital systems, and managed care organizations consistently post the highest volume of these roles.
How many provider relations specialist jobs are remote?
About 91% of provider relations specialist openings are fully remote or hybrid as of November 2026, with the highest remote share in roles focused on telephone-based provider support, credentialing coordination, and network education rather than field-based account management, which still typically requires in-person travel within an assigned region.
How do you become a provider relations specialist?
Start with a bachelor's degree in healthcare administration, business, or a related field, then gain experience in a healthcare setting such as a medical office, insurance company, or hospital billing department. Build familiarity with credentialing workflows and provider contracting basics, obtain a CAQH ProView login if possible through an employer, and pursue a Certified Provider Credentialing Specialist designation to strengthen your candidacy for mid-level roles.
Can I get a provider relations specialist job with little or no experience?
Yes, entry-level provider relations roles exist at health plans and physician management organizations for candidates who demonstrate strong communication skills and basic healthcare administrative knowledge. Customer service experience in a medical office, insurance claims processing, or benefits verification translates directly. Highlighting any exposure to provider portals, CAQH enrollment, or prior authorization workflows will differentiate you from applicants with no healthcare background.
What does the provider relations specialist interview process look like?
Most hiring processes run two to three rounds, beginning with a recruiter screen focused on your healthcare background and availability. A panel or hiring manager interview follows, often including scenario questions about managing a provider dispute or explaining a reimbursement policy change. Some employers add a written exercise or a role-play simulating a difficult provider call before extending an offer.
Where can I find and apply to provider relations specialist jobs?
You can find and apply to provider relations specialist jobs on Migrate Mate, which lists current openings from across the United States. Search the roles available, find the ones that match your background and target market, and apply directly to each listing that fits.
See All 96 Provider Relations Specialist Jobs
Find roles that match your experience and apply in just a few clicks.
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